I had an Anonymous comment this morning that referred to a message that was left for me. I did not get that message.
Remember, you can post questions or suggestions at Get Answers on the left hand side of this page or
you can also ask a specific question or send a private message at: http://theowcpclassroom.freeforums.org/
jesseslade@frontier.com
Don't be shy!
Saturday, April 2, 2011
Tuesday, March 29, 2011
Researching a Doctor
Let's start our research topic with the ECAB. I've posted the link to the ECAB sites. To look for a specific doctor, use the ECAB by topic link, you can find it on the "Links" page. When you get to the site, check the box on the right hand side of the page that says Federal Workers' Compensation and use the search bar on the left side of the page and type in the doctor's full name: Dr. John J. Smith. See what comes up.
You have to confirm the cases that come up are the same doctor you're looking for. So check not only the physician's name, but the State and speciality. Beware, some regular OWCP doctors perform exams in multiple States. So even if it's a different State than yours, it might still be your physician.
Once you've searched the doctor's full name, try other versions, such as Dr. Smith, Dr. John Smith, Dr. John Smith, Jr., Dr. John Smith, III. Whatever variations there are...try them all.
Move on from the ECAB to your normal search methods...Google, Yahoo, whatever you use. Again, search the same way: Dr. John J. Smith, Dr. John Smith, Dr. Smith. Again, use whatever information you know to confirm it's the same doctor you're looking for.
Whenever you research a physician, certain web sites will come up. Healthgrades, Vitals, etc...these sites give a basic accounting of the doctor, where they are, what they practice, reviews, stuff like that. Although these sites might give you information, you can't use it as evidence when it comes to OWCP.
Remember, when you're arguing with OWCP, you're arguing with the Government. Some random review by anyone off the Internet isn't going to get you any points with OWCP. You need solid evidence. But sometimes you can get a feeling for the doctor off these sites. If there are lots of bad reviews, that's a clue you should keep researching the doctor. If the doctor has multiple addresses, then you know you're going to need proof confirming the doctor has multiple addresses.
A basic search will give you basic information. From your basic search, follow your leads and see if they produce anything.
After your basic search, try searching:
A lot of the doctors that OWCP sends you to also work for the State workers' compensation systems, Social Security and other Government Agencies. If you find proof of that, you can use it.
Go to your State Medical Board. Check the doctor's license to make sure s/he has one and it's current and valid. State Medical Boards will also list disciplinary action and/or sanctions. Also check to make sure the doctor is Board Certified. Just type California State Medical Board or New York State Medical Board (whatever your State is) into Google or whichever search engine you use. If you find the doctor has worked in multiple States, go to the State medical board of each of those States as well.
Anything that shows the doctor works doing examinations for State workers' compensation, Social Security, OWCP, etc...Or works as an expert witness against injured parties, instead of practicing medicine, you can argue that the doctor makes his living by doing these exams and/or court cases. That their livelihood relies on it which leads to bias.
Any proof of multiple addresses can be used. The doctor may list multiple addresses on their web site. You may find multiple States from ECAB decisions or State licensing Boards. Anyplace the doctor is advertising multiple addresses, you want proof of. A physician in private practice usually doesn't have more than two or three offices at the most. So a physician that has 10, 15, 20+ different addresses and/or multiple States is more than likely no longer in private practice treating patients everyday. When I find this problem, I tell OWCP the high number of addresses is disproportionate of a physician in private practice and I include my proof of the multiple addresses. Same goes with multiple licenses in multiple states.
A physician that is licensed in multiple States, has multiple addresses and you can prove does these examinations all day, more than likely isn't practicing surgery anymore. If the doctor is a surgeon who doesn't perform surgery, you can make the argument that they are no longer up-to-date with current surgical techniques and procedures, where your physician performs surgery on a regular basis and is current with the latest techniques, procedures, technology, etc...
What you're looking for is that the physician isn't acting as a physician. S/he isn't like your doctor with one office that sees patients everyday. You're looking for anything that shows the doctor makes a living doing nothing but performing exams for Government Agencies; OWCP, Social Security, State Workers' Compensation, etc...or a doctor that regularly testifies in court.
I also check certain web sites. These sites contract out Independent Medical Examiners, Expert Witnesses, etc...I find a lot of OWCP's physician's are also listed on these sites. I'm putting those sites on the "Links" page under: Research, Physicians.
If you find a lot of the information I've talked about here, you might also want to do a Freedom of Information Act, (FOIA) request on the doctor. I've put a sample letter on the "How To" page. With a FOIA request, you can ask OWCP for any complaint's against the doctor and how many times they've been used as an IME in all Districts in the last four years.
You can't request any information on how many second opinions the doctor has done for OWCP since OWCP doesn't keep track of that information. But IME's are to be chosen at random and because of their medical importance, OWCP does keep records on how many times the physician was used for an IME. If you find a doctor has been used as an IME on a fairly regular basis, then you can argue OWCP is not choosing this physician at random. Especially if the doctor is from a large city. In a large city, a physician being chosen at random, wouldn't be chosen more than two or three times at most.
If you have a complaint about the physician, you must send that complaint to OWCP PRIOR to any examination. If you send a complaint after your exam, OWCP will just come back saying you just didn't like the physician's report. If the exam is scheduled too soon and you can't get all your research in, do a basic search. If it looks like you might have to file a complaint, then write your CE a letter stating that your basic research on the physician may lead to a complaint, however the Office did not give you enough time to complete your research. That way you still have something in PRIOR to your appointment.
This information also works for any District Medical Advisor, (DMA) or other physician that OWCP may use. For nurses, change the State medical board to the State Nursing Board. For physical therapists use the State Physical Therapy Board. Don't just research the physicians, research the physical therapists, nurses, FCE facilities, any medical personnel that might have a negitive effect on your claim.
If you've ever been sent to a second opinion or IME, even if you don't have an appointment scheduled, research the physician's you've already been sent to. See if you find anything. Practice researching so that when you need it, you're familiar with what you're looking for. OWCP is just like anything else, no one's good at it at first, but when you practice, it gets easier.
You have to confirm the cases that come up are the same doctor you're looking for. So check not only the physician's name, but the State and speciality. Beware, some regular OWCP doctors perform exams in multiple States. So even if it's a different State than yours, it might still be your physician.
Once you've searched the doctor's full name, try other versions, such as Dr. Smith, Dr. John Smith, Dr. John Smith, Jr., Dr. John Smith, III. Whatever variations there are...try them all.
Move on from the ECAB to your normal search methods...Google, Yahoo, whatever you use. Again, search the same way: Dr. John J. Smith, Dr. John Smith, Dr. Smith. Again, use whatever information you know to confirm it's the same doctor you're looking for.
Whenever you research a physician, certain web sites will come up. Healthgrades, Vitals, etc...these sites give a basic accounting of the doctor, where they are, what they practice, reviews, stuff like that. Although these sites might give you information, you can't use it as evidence when it comes to OWCP.
Remember, when you're arguing with OWCP, you're arguing with the Government. Some random review by anyone off the Internet isn't going to get you any points with OWCP. You need solid evidence. But sometimes you can get a feeling for the doctor off these sites. If there are lots of bad reviews, that's a clue you should keep researching the doctor. If the doctor has multiple addresses, then you know you're going to need proof confirming the doctor has multiple addresses.
A basic search will give you basic information. From your basic search, follow your leads and see if they produce anything.
After your basic search, try searching:
Dr. John Smith expert witnessAny law suit that includes the doctor can be used. The OWCP doesn't have to accept another court's opinion but they are supposed to take it into consideration. Some OWCP doctor's are regularly involved in testifying in court cases as 'experts' so any information you can find about that is helpful.
Dr. John Smith IME (that's an Independent Medical Examiner/Evaluator)
Dr. John Smith QME (that's a Qualified Medical Examiner/Evaluator)
Dr. John Smith malpractice
Dr. John Smith workers' compensation
Dr. John Smith YOUR STATE workers' compensation (Example: California workers' compensation. New York workers' compensation)
Dr. John Smith law suit
A lot of the doctors that OWCP sends you to also work for the State workers' compensation systems, Social Security and other Government Agencies. If you find proof of that, you can use it.
Go to your State Medical Board. Check the doctor's license to make sure s/he has one and it's current and valid. State Medical Boards will also list disciplinary action and/or sanctions. Also check to make sure the doctor is Board Certified. Just type California State Medical Board or New York State Medical Board (whatever your State is) into Google or whichever search engine you use. If you find the doctor has worked in multiple States, go to the State medical board of each of those States as well.
Anything that shows the doctor works doing examinations for State workers' compensation, Social Security, OWCP, etc...Or works as an expert witness against injured parties, instead of practicing medicine, you can argue that the doctor makes his living by doing these exams and/or court cases. That their livelihood relies on it which leads to bias.
Any proof of multiple addresses can be used. The doctor may list multiple addresses on their web site. You may find multiple States from ECAB decisions or State licensing Boards. Anyplace the doctor is advertising multiple addresses, you want proof of. A physician in private practice usually doesn't have more than two or three offices at the most. So a physician that has 10, 15, 20+ different addresses and/or multiple States is more than likely no longer in private practice treating patients everyday. When I find this problem, I tell OWCP the high number of addresses is disproportionate of a physician in private practice and I include my proof of the multiple addresses. Same goes with multiple licenses in multiple states.
A physician that is licensed in multiple States, has multiple addresses and you can prove does these examinations all day, more than likely isn't practicing surgery anymore. If the doctor is a surgeon who doesn't perform surgery, you can make the argument that they are no longer up-to-date with current surgical techniques and procedures, where your physician performs surgery on a regular basis and is current with the latest techniques, procedures, technology, etc...
What you're looking for is that the physician isn't acting as a physician. S/he isn't like your doctor with one office that sees patients everyday. You're looking for anything that shows the doctor makes a living doing nothing but performing exams for Government Agencies; OWCP, Social Security, State Workers' Compensation, etc...or a doctor that regularly testifies in court.
I also check certain web sites. These sites contract out Independent Medical Examiners, Expert Witnesses, etc...I find a lot of OWCP's physician's are also listed on these sites. I'm putting those sites on the "Links" page under: Research, Physicians.
If you find a lot of the information I've talked about here, you might also want to do a Freedom of Information Act, (FOIA) request on the doctor. I've put a sample letter on the "How To" page. With a FOIA request, you can ask OWCP for any complaint's against the doctor and how many times they've been used as an IME in all Districts in the last four years.
You can't request any information on how many second opinions the doctor has done for OWCP since OWCP doesn't keep track of that information. But IME's are to be chosen at random and because of their medical importance, OWCP does keep records on how many times the physician was used for an IME. If you find a doctor has been used as an IME on a fairly regular basis, then you can argue OWCP is not choosing this physician at random. Especially if the doctor is from a large city. In a large city, a physician being chosen at random, wouldn't be chosen more than two or three times at most.
If you have a complaint about the physician, you must send that complaint to OWCP PRIOR to any examination. If you send a complaint after your exam, OWCP will just come back saying you just didn't like the physician's report. If the exam is scheduled too soon and you can't get all your research in, do a basic search. If it looks like you might have to file a complaint, then write your CE a letter stating that your basic research on the physician may lead to a complaint, however the Office did not give you enough time to complete your research. That way you still have something in PRIOR to your appointment.
This information also works for any District Medical Advisor, (DMA) or other physician that OWCP may use. For nurses, change the State medical board to the State Nursing Board. For physical therapists use the State Physical Therapy Board. Don't just research the physicians, research the physical therapists, nurses, FCE facilities, any medical personnel that might have a negitive effect on your claim.
If you've ever been sent to a second opinion or IME, even if you don't have an appointment scheduled, research the physician's you've already been sent to. See if you find anything. Practice researching so that when you need it, you're familiar with what you're looking for. OWCP is just like anything else, no one's good at it at first, but when you practice, it gets easier.
Sunday, March 27, 2011
The Paper Trail
I hear it all the time, a claimant has called OWCP and nothing happens. They leave messages for their CE and get no response, so they call again, leave another message...nothing happens except they get frustrated. Or maybe the CE does call back, promises action but then doesn't follow up. Maybe you're even lucky enough to play phone tag for a week. It's common. Happens everyday.
Personally, I don't do phone calls with OWCP. When you talk to your CE a CA-110 is supposed to be completed. This form basically says there was a call and OWCP's version of who said what. Problem is, when you get a copy of your file, your telephone calls are often misrepresented on a CA-110 and a lot of times, your issue didn't get fixed or answered.
If OWCP happens to call me, I tell whoever is on the other end that I would prefer to have the information in writing. I follow that up with a letter regarding the call, who said what and how I'm expecting confirmation in writing.
Call your CE and you've got no proof what was or wasn't said. No proof of what is or isn't going to get done. All you've got is OWCP's version of a phone call in your file.
Me, I like the paper trail. I can state all the facts in a letter, I can be clear and concise. I can cite the FECA Manuals and ECAB decisions to prove my point. If my letter doesn't get answered, I can send a second request or a third if I have to. If I need to go higher up the 'food chain' to a District director or member of Congress, I have clear proof of what I said, when I said it, how many times I said it and who I said it to. Not OWCP's version of events, but actual proof they can hold in their hands. No one can say it didn't happen.
I can send my letter delivery confirmation and print out proof OWCP received it, right down to the time of day. I pick up a stack of delivery confirmation receipts at my Post Office and I put the confirmation number on every piece of paper I'm sending under that number. I can't even count the number of times I've received a letter from OWCP saying they didn't get a letter and I've been able to prove it was in fact received.
When OWCP answers my letter, I've got written proof on OWCP letterhead of what was or wasn't said. As a bonus, it's even signed, so I've got someone to name later if I need to. If later OWCP tries to deny what they said, I can quote their letters and prove it. Besides, I've never been disappointed by what they will actually put in writing. Their lack of knowledge shines through and just makes my job that much easier.
If you've found this site, you've probably read other claimant's stories. One common theme seems to be that OWCP doesn't always do or say the right thing. If it happens to you, how can you expect to overturn a decision, or change a conclusion, right a wrong if you have no paper trail? Think about this, all of OWCP's letters are form letters. That letter you got from them isn't special. It's a form letter and they plug in your specifics. It's not the form part of the letter they get wrong...it's your specifics. The more you let them write to you, the more weapons you have to use against them. The more you have to use against them, the easier it is to overturn a decision or change a conclusion or right a wrong.
Hey, I'm not going to sit here and tell you anything with OWCP is easy. I don't know of anyone who didn't have to fight a denial, bad decision or questionable medical opinion (or some other thing) at some point in their claim. Some people get nothing but denials and fighting even when they've proven their case six ways from Sunday. You can't fight if you don't have any weapons, you can't fight with only OWCP's version of events. If you want weapons, they're in your paper trail.
Personally, I don't do phone calls with OWCP. When you talk to your CE a CA-110 is supposed to be completed. This form basically says there was a call and OWCP's version of who said what. Problem is, when you get a copy of your file, your telephone calls are often misrepresented on a CA-110 and a lot of times, your issue didn't get fixed or answered.
If OWCP happens to call me, I tell whoever is on the other end that I would prefer to have the information in writing. I follow that up with a letter regarding the call, who said what and how I'm expecting confirmation in writing.
Call your CE and you've got no proof what was or wasn't said. No proof of what is or isn't going to get done. All you've got is OWCP's version of a phone call in your file.
Me, I like the paper trail. I can state all the facts in a letter, I can be clear and concise. I can cite the FECA Manuals and ECAB decisions to prove my point. If my letter doesn't get answered, I can send a second request or a third if I have to. If I need to go higher up the 'food chain' to a District director or member of Congress, I have clear proof of what I said, when I said it, how many times I said it and who I said it to. Not OWCP's version of events, but actual proof they can hold in their hands. No one can say it didn't happen.
I can send my letter delivery confirmation and print out proof OWCP received it, right down to the time of day. I pick up a stack of delivery confirmation receipts at my Post Office and I put the confirmation number on every piece of paper I'm sending under that number. I can't even count the number of times I've received a letter from OWCP saying they didn't get a letter and I've been able to prove it was in fact received.
When OWCP answers my letter, I've got written proof on OWCP letterhead of what was or wasn't said. As a bonus, it's even signed, so I've got someone to name later if I need to. If later OWCP tries to deny what they said, I can quote their letters and prove it. Besides, I've never been disappointed by what they will actually put in writing. Their lack of knowledge shines through and just makes my job that much easier.
If you've found this site, you've probably read other claimant's stories. One common theme seems to be that OWCP doesn't always do or say the right thing. If it happens to you, how can you expect to overturn a decision, or change a conclusion, right a wrong if you have no paper trail? Think about this, all of OWCP's letters are form letters. That letter you got from them isn't special. It's a form letter and they plug in your specifics. It's not the form part of the letter they get wrong...it's your specifics. The more you let them write to you, the more weapons you have to use against them. The more you have to use against them, the easier it is to overturn a decision or change a conclusion or right a wrong.
Hey, I'm not going to sit here and tell you anything with OWCP is easy. I don't know of anyone who didn't have to fight a denial, bad decision or questionable medical opinion (or some other thing) at some point in their claim. Some people get nothing but denials and fighting even when they've proven their case six ways from Sunday. You can't fight if you don't have any weapons, you can't fight with only OWCP's version of events. If you want weapons, they're in your paper trail.
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